BMC Anesthesiology最新文献

{"title":"Early deep sedation was associated with post-hospital one-year mortality in critically ill surgical patients: a propensity-matched retrospective cohort study.","authors":"Peng-Yen Wu, Shang-Yi Lee, Li-Ting Wong, Wen-Cheng Chao","doi":"10.1186/s12871-025-03137-4","DOIUrl":"10.1186/s12871-025-03137-4","url":null,"abstract":"<p><strong>Objective: </strong>Sedation is a crucial issue in critical care, but the impact of early deep sedation on post-hospital mortality in critically ill surgical patients remains unclear.</p><p><strong>Methods: </strong>We linked the 2015-2020 critical care database at Taichung Veterans General Hospital with the nationwide death registration in Taiwan. Log-rank test was used to estimate survival curves between patients with and without deep sedation, defined by the average Richmond Agitation-Sedation Scale (RASS) level within the first 3 days equal to or lower than - 3. A multivariable Cox proportional hazards regression model was used to determine hazard ratios (HR) and 95% confidence intervals (CI). Furthermore, we used propensity score-matching (PSM) analysis to validate the association.</p><p><strong>Results: </strong>A total of 7,135 critically ill surgical patients were enrolled, and 13.7% of them experienced early deep sedation. Independent predictors for post-hospital one-year mortality included old age, male, more comorbidities, high acute physiology and chronic health evaluation (APACHE) II score, and low body mass index. We noted that receiving midazolam (aHR 1.368, 95% CI 1.052-1.780) or propofol (aHR 1.459, 95% CI 1.136-1.874) was associated with increased mortality compared with dexmedetomidine. Early deep sedation was independently associated with post-hospital mortality after adjusting for covariates (aHR 1.216, 95% CI 1.019-1.452), and the association remained robust in the PSM analysis (aHR 1.313, 95% CI 1.054-1.636).</p><p><strong>Conclusion: </strong>We identified the association between early deep sedation and post-hospital mortality, a modifiable factor, in critically ill surgical patients. Further prospective studies are warranted to confirm our findings.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"268"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The extent of Skeletal muscle wasting in prolonged critical illness and its association with survival: insights from a retrospective single-center study.","authors":"Johannes Kolck, Clarissa Hosse, Uli Fehrenbach, Nick-Lasse Beetz, Timo Alexander Auer, Christian Pille, Dominik Geisel","doi":"10.1186/s12871-025-03142-7","DOIUrl":"10.1186/s12871-025-03142-7","url":null,"abstract":"<p><strong>Objective: </strong>Muscle wasting in critically ill patients, particularly those with prolonged hospitalization, poses a significant challenge to recovery and long-term outcomes. The aim of this study was to characterize long-term muscle wasting trajectories in ICU patients with acute respiratory distress syndrome (ARDS) due to COVID-19 and acute pancreatitis (AP), to evaluate correlations between muscle wasting and patient outcomes, and to identify clinically feasible thresholds that have the potential to enhance patient care strategies.</p><p><strong>Materials and methods: </strong>A collective of 154 ICU patients (100 AP and 54 COVID-19 ARDS) with a minimum ICU stay of 10 days and at least three abdominal CT scans were retrospectively analyzed. AI-driven segmentation of CT scans quantified changes in psoas muscle area (PMA). A mixed model analysis was used to assess the correlation between mortality and muscle wasting, Cox regression was applied to identify potential predictors of survival. Muscle loss rates, survival thresholds and outcome correlations were assessed using Kaplan-Meier and receiver operating characteristic (ROC) analyses.</p><p><strong>Results: </strong>Muscle loss in ICU patients was most pronounced in the first two weeks, peaking at -2.42% and - 2.39% psoas muscle area (PMA) loss per day in weeks 1 and 2, respectively, followed by a progressive decline. The median total PMA loss was 48.3%, with significantly greater losses in non-survivors. Mixed model analysis confirmed correlation of muscle wasting with mortality. Cox regression identified visceral adipose tissue (VAT), sequential organ failure assessment (SOFA) score and muscle wasting as significant risk factors, while increased skeletal muscle area (SMA) was protective. ROC and Kaplan-Meier analyses showed strong correlations between PMA loss thresholds and survival, with daily loss > 4% predicting the worst survival (39.7%).</p><p><strong>Conclusions: </strong>To our knowledge, This is the first study to highlight the substantial progression of muscle wasting in prolonged hospitalized ICU patients. The mortality-related thresholds for muscle wasting rates identified in this study may provide a basis for clinical risk stratification. Future research should validate these findings in larger cohorts and explore strategies to mitigate muscle loss.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"266"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia management of complex head and face injury caused by bear bite: a case report.","authors":"Shumei Wu, Jiayao Zhang, Hongcai Zhang, Yan Zhang","doi":"10.1186/s12871-025-03129-4","DOIUrl":"10.1186/s12871-025-03129-4","url":null,"abstract":"<p><strong>Background: </strong>Bear bites often cause serious injuries to patients such as on the face, neck, limbs, head and other parts, resulting in difficult airways and presenting great challenges to anesthesia management.</p><p><strong>Case presentation: </strong>This paper reports a case of a 35-year-old Tibetan woman who was severely injured on the face by a bear's attack while grazing, resulting in a difficult airway. Awake tracheal intubation was adopted and tracheostomy was performed during the operation. Airway management of the patient was successfully carried out. During the initial hospitalization, there were no complications related to tracheal intubation in any of the 9 operations, and the patient was discharged smoothly.</p><p><strong>Conclusion: </strong>The key to ensuring the safety and success of the operation is to develop an personalized anesthesia plan based on the specific situation of patients in the difficult airways caused by complex head and face trauma caused by bear bites.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"260"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standards of practice for peripheral nerve blocks at a tertiary care center in a low-middle income country- a prospective observational study.","authors":"Heena Purshotamdas Bhupta, Priyanka Kini, Nisha Sara M Jacob","doi":"10.1186/s12871-025-03125-8","DOIUrl":"10.1186/s12871-025-03125-8","url":null,"abstract":"<p><strong>Background: </strong>Peripheral nerve blocks (PNB) have gained tremendous interest as a means of providing anesthesia and analgesia. Heterogeneity exists in the standards of practice (SoP) for PNB, especially in resource limited settings. Therefore, this study aimed to determine the SoP for administration of PNB at a tertiary care, University teaching hospital, in a low-middle income country (LMIC).</p><p><strong>Methods: </strong>This was a prospective observational study conducted between September 2021 and March 2023. The SoP were collected through either direct or indirect observation, using a self-developed proforma. Data were collected for various domains and were mapped to structure, process and outcome. They were then benchmarked to identify best practices and deficiencies.</p><p><strong>Results: </strong>A total of 386 PNBs were recorded, of which 196 (50.8%) were directly observed. Majority were administered to low-risk individuals without comorbidities (61.9%). In the structure metrics resuscitation equipment was available in 76% while availability of resuscitation drugs (29%) was identified as needing improvement. Individual components of process metrics such as intravenous access, use of personal protective equipment, ultrasound guided block technique and use of short bevel needles exceeded the 95% benchmark, while components such as monitoring (54%), aseptic site preparation (76.5%), the Stop Before You Block procedure (61.9%) and use of block additives (70.2%) fell short of the benchmark. Postoperative multimodal analgesia prescription (4.7%) was identified as needing improvement. Of the outcome metrics, while immediate post-block complications (0%) and conversion rate to general anesthesia (8.3%) exceeded the benchmark (< 10%), cumulative toxic dose was exceeded (36.6%) when a mixture of local anesthetics was used.</p><p><strong>Conclusion: </strong>Standards of practice for structure, process and outcome were partly achieved for PNB at this tertiary care center in a low-middle income country. Strategies to improve SoP have been proposed and will need to be evaluated in future quality improvement initiatives.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"261"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of exhaled breath volatile organic compounds with surgical traumatic stress.","authors":"Qifeng Wang, Yuyi Zhao, Shikuo Li, Xuehan Li, Haiyan Wang, Yunxia Zuo","doi":"10.1186/s12871-025-03140-9","DOIUrl":"10.1186/s12871-025-03140-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored the association of surgical traumatic stress with volatile organic compounds (VOCs) in breath.</p><p><strong>Methods: </strong>Exhaled breath and blood samples were collected from 105 patients under general anesthesia at three time points: prior to incision (Pre-op), 2 h after incision (Intra-op), and prior to extubation (End-op). Differential mass spectral features between these time points were screened. Traumatic stress-related biomarker detection and mixed-effects model analysis were performed to define correlations and significance between parameters. Subgroup analysis was conducted to test the ability of mass spectral features to distinguish different surgical routes (open vs. laparoscopic).</p><p><strong>Results: </strong>The abundances of mass spectral features changed significantly between these time points. All stress-related biomarker increased dramatically in the Intra-op group and decreased significantly after operation. Mixed-effects model analysis revealed that several features were significantly correlated with stress biomarkers. Most importantly, subgroup analysis revealed that different surgical routes failed to be distinguished by mass spectral features.</p><p><strong>Conclusion: </strong>Surgical traumatic stress may change the exhaled breath mass spectral features in perioperative patients, providing preliminary evidence for mass spectral features use in future monitoring of this stress response.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"265"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and evaluation of a nomogram prediction model for the risk of epistaxis following nasotracheal intubation: a single-center retrospective cohort study.","authors":"Jie Chen, Hao Fan, Yuxing Wang, Yuhang Zhu, Ren Zhou, Hua Kang, Hong Jiang","doi":"10.1186/s12871-025-03132-9","DOIUrl":"10.1186/s12871-025-03132-9","url":null,"abstract":"<p><strong>Background and objective: </strong>Nasotracheal intubation (NTI) is a common procedure in oral and maxillofacial surgery; however, it is associated with a significant risk of post-procedural epistaxis. This study aims to identify risk factors for epistaxis following NTI and develop a nomogram-based prediction model to provide clinicians with a reliable risk assessment tool.</p><p><strong>Methods: </strong>This single-center, retrospective study included 640 adult patients who underwent NTI at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, between June 2020 and December 2021. Clinical data and imaging findings were collected, and the least absolute shrinkage and selection operator (LASSO) regression, followed by multivariate logistic regression analysis, were used to identify predictors of epistaxis. A nomogram prediction model was constructed, and its performance was evaluated using receiver operating characteristic (ROC) curves, the Hosmer-Lemeshow test, and decision curve analysis.</p><p><strong>Results: </strong>A total of 574 patients were included. Five epistaxis risk predictors were identified: age, history of radiotherapy/chemotherapy, nasal intubation duration, maximum nasal septum deviation on the coronal plane, and location of this deviation on the cross-section. The model's area under curve (AUC) was 0.957 in the training set and 0.900 in the validation set, indicating good discrimination and accuracy. The calibration curve was well-fitted, and decision curve analysis showed good clinical utility.</p><p><strong>Conclusion: </strong>The nomogram developed in this study effectively predicts the risk of epistaxis following NTI, offering clinicians an intuitive and practical decision-making tool. This model may help reduce adverse events and enhance surgical safety by guiding preoperative risk stratification and personalized management strategies.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"264"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A visit to preanesthesia clinic can promote post-anesthesia early recovery in pediatric patients undergoing minor surgery: a retrospective study from a single center.","authors":"Huanqi Luo, Dongdong Zhang, Yujun Lian, Yunfei Yan, Ting Zhang, Yanyan Sun","doi":"10.1186/s12871-025-03136-5","DOIUrl":"10.1186/s12871-025-03136-5","url":null,"abstract":"<p><strong>Background: </strong>The preanesthesia clinic has been established for decades, with numerous studies confirming its advantages. However, in certain countries or regions, preanesthesia clinic services have yet to be implemented or have encountered resistance during their development. Moreover, there is little literature addressing whether preanesthesia clinic benefits healthy patients undergoing minor surgical procedures. Therefore, this study was conducted to explore whether the preanesthesia assessment model influences short-term post-anesthesia recovery, aiming to uncover additional benefits of preanesthesia clinic.</p><p><strong>Methods: </strong>Pediatric patients aged 1 to 18 years underwent elective adenoidectomy or adenotonsillectomy under general anesthesia were included, who were divided into the two groups according to different models of preoperative anesthesia evaluation. The primary outcomes were the extubation time and the length of postanesthetic care unit stay. The secondary outcomes were the length of hospital stay, the medical costs, and postoperative complications.</p><p><strong>Results: </strong>Total 1553 eligible pediatric patients were enrolled, 492 finished preoperative evaluation in preanesthesia clinic, another 1061 in wards. Compared with the model of preoperative anesthesia evaluation in ward, the length of postanesthetic care unit stay, the examination costs, the costs of laboratory test, and the total medical costs were significantly lower in the preanesthesia clinic group.</p><p><strong>Conclusions: </strong>Preanesthesia clinic can significantly shorten the post-anesthesia recovery time for healthy children undergoing minor surgeries and can reduce overall medical costs.</p><p><strong>Trial registration: </strong>The study was retrospectively registered at Chictr.org.cn with the number ChiCTR2300070212 on 04/05/2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"259"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of remimazolam in non-intubated video-assisted thoracic surgery: a retrospective cohort study.","authors":"Po-Yu Huang, Hui-Hsuan Ke, Hung-Wei Cheng, Po-Kuei Hsu, Wen-Kuei Chang, Chien-Kun Ting","doi":"10.1186/s12871-025-03131-w","DOIUrl":"10.1186/s12871-025-03131-w","url":null,"abstract":"<p><strong>Background: </strong>Single-incision video-assisted thoracoscopic surgery (VATS) is safer, more efficient, and less invasive, with fewer complications and shorter hospital stays. When combined with non-intubated spontaneous breathing, it enhances recovery by reducing complications, operating time, and anesthesia duration. Remimazolam, an ultrashort-acting benzodiazepine, provides rapid onset and offset with minimal respiratory depression, making it promising for non-intubated VATS (NIVATS).</p><p><strong>Methods: </strong>This retrospective study was conducted at Taipei Veterans General Hospital, Taiwan, and included 62 patients who underwent single-port NIVATS. Of these, 41 patients received propofol with dexmedetomidine (August 2019-December 2021), and 21 patients received remimazolam with dexmedetomidine (January 2023-December 2023). The primary outcome was the change in arterial carbon dioxide pressure (ΔPaCO2), while secondary outcomes included anesthesia duration, surgery duration, and postoperative hospital stay. Propensity score matching controlled for confounders, and subgroup analyses compared thoracic epidural anesthesia (TEA) with paravertebral block (PVB).</p><p><strong>Results: </strong>The patients in the remimazolam group showed a smaller PaCO2 increase (6.84 ± 6.01 mmHg vs. 14.42 ± 11.55 mmHg; p = 0.0113), shorter surgery duration (50.19 ± 26.12 min vs. 83.54 ± 24.86 min; p < 0.0001), and shorter postoperative hospital stay compared with those in the propofol group. No significant between-group differences were found with regard to anesthesia duration. Subgroup analysis showed consistent outcomes between TEA and PVB groups, supporting the flexibility of remimazolam-based sedation. None of the patients required flumazenil reversal.</p><p><strong>Conclusions: </strong>This study demonstrated effective sedation and superior respiratory stability with the use of remimazolam-dexmedetomidine combination in NIVATS, suggesting it to be a viable alternative. Further studies are needed to confirm these findings in diverse surgical settings.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"263"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between transtracheal and intravenous 2% lignocaine in attenuating hemodynamic stress response following direct laryngoscopy and endotracheal intubation: a randomized controlled trial.","authors":"Monotosh Pramanik, Uddalak Chattopadhyay, Shalini Chaudhuri, Syed Sadaqat Hussain, Nikhil Kumar Singh, Sandipan Banerjee, Shreyasi Ray, Jyotirmay Kirtania","doi":"10.1186/s12871-025-03102-1","DOIUrl":"10.1186/s12871-025-03102-1","url":null,"abstract":"<p><strong>Background and aims: </strong>Lignocaine is used through various routes to mitigate the hemodynamic surge associated with laryngoscopy and endotracheal intubation during general anesthesia. This study hypothesized that post-induction administration of transtracheal 2% lignocaine at 1.5 mg/kg would have a similar effect to intravenous 2% lignocaine at the same dosage, providing an alternative for attenuating the hemodynamic stress response.</p><p><strong>Methods: </strong>A total of 138 consenting patients were randomized into two groups. Following induction, Group IV patients received 2% lignocaine at 1.5 mg/kg intravenously, while Group TT patients received 2% lignocaine at 1.5 mg/kg transtracheally. The primary outcome was the comparison of hemodynamic responses at different time points around intubation. The secondary outcome was the incidence of sore throat. Data analyses were done using the Statistical Software Jupyter Notebook, running in a Python 3.11 environment.</p><p><strong>Results: </strong>Post-induction hypotension was significantly less pronounced in the TT group [Mean blood pressure (median with IQR) IV group 68(60-78) mm of Hg vs. TT group 71(66-82.25) mm of Hg, P = 0.018]. TT group patients experienced a significantly smaller post-intubation surge at 3 minutes in blood pressure and heart rate compared to the IV group [Mean blood pressure (median with IQR) IV group 79(71-87) mm of Hg vs. TT group 73(65-81) mm of Hg, P = 0.009 and Heart rate (median with IQR) IV group 80(70-94) per minute vs. 71.5(64-82.75) per minute P = 0.015].</p><p><strong>Conclusion: </strong>Transtracheal lignocaine is more likely to maintain stable hemodynamics during intubation compared to intravenous lignocaine.</p><p><strong>Trial registration: </strong>CTRI/2023/06/054125 [Registered on: 19/06/2023]. This trial is registered with the Clinical Trial Registry of India https://ctri.nic.in/Clinicaltrials/login.php .</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"262"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial.","authors":"Baohua Zhang, Yang Han, Huan He, Li Jin, Lidong Zhang","doi":"10.1186/s12871-025-03134-7","DOIUrl":"10.1186/s12871-025-03134-7","url":null,"abstract":"<p><strong>Background: </strong>We aimed to determine whether preoperative chewing gum is non-inferior to Chlorhexidine (CHX) mouthwash in reducing halitosis in patients undergoing elective general anesthesia with endotracheal intubation.</p><p><strong>Methods: </strong>We conducted a randomized, single-blind, non-inferiority controlled trial involving patients undergoing surgery requiring endotracheal intubation for ≤ 3 h. Participants were randomly assigned to either the CHX mouthwash group (Group M) or the chewing gum group (Group N). Thirty minutes before general anesthesia, patients in Group M rinsed their mouths with 10 ml of CHX mouthwash, while those in Group N chewed Trident mint gum. The primary outcome was the incidence of halitosis in both groups, assessed before endotracheal intubation and at extubation.</p><p><strong>Results: </strong>A total of 733 patients were included, with 365 patients in Group M and 368 patients in Group N. The incidence of halitosis in both groups was significantly reduced compared to baseline. Before extubation, the improvement in halitosis was greater in Group N than in Group M (P < 0.05). After extubation, the improvement in halitosis in Group N was non-inferior to that in Group M (Z = 1.96, 95% CI: -0.0898 to 0.0944, p = 0.0023).</p><p><strong>Conclusions: </strong>In patients undergoing elective general anesthesia with endotracheal intubation, chewing gum was found to be non-inferior to CHX mouthwash in improving postoperative halitosis.</p><p><strong>Trial registration: </strong>Chictr.org.cn ChiCTR2400082035 (date of registration: 19/03/2024).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"257"},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}